


48ers

by rae_z



Category: Criminal Minds, NCIS
Genre: Angst with a Happy Ending, F/M, Fluff and Angst, Paramedic - Freeform
Language: English
Status: In-Progress
Published: 2015-10-01
Updated: 2015-10-01
Packaged: 2018-04-24 05:46:41
Rating: Mature
Warnings: Graphic Depictions Of Violence
Chapters: 2
Words: 3,530
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/4907704
Author URL: https://archiveofourown.org/users/rae_z/pseuds/rae_z
Summary: <blockquote class="userstuff">
              <p>A lot can happen in forty-eight hours. <br/>Add a blue-haired Paramedic, her Indian partner, and their trainee EMT on those 48 hour shifts, those things become a lot more interesting. These are the stories of Ambulance 158 of the Metro DC EMS Service.</p><p>The team of paramedics (and EMTs) come in contact with those we love at the BAU and at NCIS. Fluff. Lots of fluff. Lots of violence. Lots of happy endings. Faintly connected one-shots.</p>
            </blockquote>





	1. Wednesday, 15/03/2009, 1745 hours: Aaron Hotchner

1730: Ambulance 158 responding to an unresponsive stab victim  
1734: 158 on scene.  
________________________  
"What's this guy's name again?"   
"Hotchner. Aaron Hotchner. Forty-three year old male, stab victim." Kat said tersely, "Hari, get bleeding controlled, Jess, you're on airway and vitals."   
Jess looked worried.  
"Should we call for ALS?"   
Kat gave her a look.   
"We are ALS."  
"Oh, right.   
Katrine McArthur entered the apartment of one Aaron Hotchner, declaring patient arrival time at 1738 hours. The man was wearing a suit, but that was quickly discarded in favor of nothing at all. Kat palpated over the abdomen gently and her face tightened.   
"Load and go, guys. Bleeding controlled, Hari?"  
Hari nodded, finishing packing the wounds with gauze. Jess had her lower lip caught between her teeth, a piece of fiery red hair falling over her eyes, as she deflated the blood pressure cuff around Hotchner's arm.   
“I couldn’t catch the diastolic.” she said, “So blood pressure is ninety over p.”   
Whenever Kat McArther is annoyed, worried, or pissed off, she wiggles her nose like a rabbit. It’s a habit many men and a few women have found endearing, and it’s a habit Kat McArther doesn’t realize she’s doing.   
She wiggled her nose and said,  
“Hari, get us there quick. We’ve got to take the stairs. This guy doesn’t have time to wait for an elevator. Let’s go.”   
Hari and Kat strapped Hotchner to a backboard, collared and blocked his head, and power-lifted him onto the waiting pram. They strapped him in criss-cross style - bumpy roads ahead - and rushed out of the room. Thankfully, Hotchner’s place was only three floors up, and they made the journey in a heartbeat.   
Jess glanced out the front door and groaned.   
“Why is it that we always get the circuses? Why can’t 159 get the circuses? Maria loves cameras.”   
“Hell if I know, Nonu.” Hari said tightly, “Get them to make a hole. Be loud and mean about it.”   
Jess opened the doors, let the two out, and shouted,   
“Out of our way! Make a hole! Out! Get out! Out! No freaking comment, lady!”   
Grumbling, the press circus made a hole and let the group load Hotchner into the ambulance. Then they sped off, Hari running an urgent Code One - lights, sirens, and the Opticom systems all blaring. For the moment, Hotchner’s condition was stable, so with Jess still continuously monitoring his vitals, Kat called into medical direction.   
“I’mma need a t-ten room,” Kat started, “just to get that out of the way. Aaron Hotchner, forty-three, male, stabbed nine times in the chest and abdomen. Unresponsive. blood pressure dangerously low. Uncertain medical history, was found in an apartment off Federal. Dispatch stated that callers-in said they heard gunshots and a man screaming. Started two IVs with one unit of o-neg, one unit of morphine. Patient hasn’t responded. Bleeding is controlled but abdomen is tender and stiff. Dude, this guy is bad. ETA three minutes. Comin’ in real hot.”   
“Roger. T-ten room approved. Over and out, chica.”   
Hari swung into the specialized bay at Washington General for t-ten patients. Kat gave the drop report as they passed him onto the trauma nurses, and mercifully had time to change and fill out PCR forms.   
As Kat was putting the finishing touches on the patient narrative, Jess came out of the bathroom, looking pale and shaking ever so slightly. Kat opened her mouth to say something, but Emily, the greatest trauma nurse in the world, at least in Kat’s opinion, put an arm around her shoulders and guided her off.   
A couple of minutes later Jess came back out, looking happier and holding a cookie in her left hand.   
“Emily!” Kat complained, “I don’t get a cookie?”   
Emily planted a kiss on Kat’s cheek.   
“You live with me. Don’t complain.”   
Kat rolled her eyes and threw an arm around Jess’ shoulder.   
“She knock some sense into you, kiddo?” Kat said playfully, “Because you should have been cleaning the bus.”   
“You’re so mean to me.”   
“You’re lucky to be with a paramedic as great as me.”   
“Shut up.”   
“Don’t tell me what to do.”   
“Go clean the bus, kid, or I’ll tell everybody about your first day here!”   
Jess groaned and went to clean the ambulance. Emily wrapped an arm around Kat’s waist and said,  
“Call okay? Jess didn’t tell me much.” “Stab victim. Nine times. Almost made me a little sick.”   
“Ah, geez. In surgery?”  “Yeah.”   
Three days later, on an asthma patient with a King tube down her larynx who woke up midway through, Kat decided randomly to check in on this Aaron Hotchner. In a lull between calls, Kat went over to Emily’s desk and said,  
“I don’t suppose you know where that Hotchner is?”  
“Um, I do.”   
Kat grinned and leaned a little closer.  
“What do I have to do to get this info?”   
“Bring home some good champagne tonight.”   
“Deal.”   
“Room 120, upstairs.”   
Kat caught Jess and Hari on their way out to clean the bus and said,  
“I’mma check on Hotchner. You guys wanna come?”   
Jess nodded.  
“Sure. You know where he is?”   
“Yep. Hari?”  “I go where you go, my liege.” said Hari.  
Kat grinned, hesitated so the two were in front of her, then leapt on Hari’s back.  
“Onward, brave steed!” she cried, “Onward and upward, to floor two!”  
“Ugh, Emily feeds you too much.” Hari groaned as they got in the elevator.  
“Yeah, but it’s delicious.”   
The three made quite a scene in the hospital. Kat’s hair was always a bright sky blue tied up in a messy bun, and she had a tattoo down her right arm - several black bands in varying order. Kat, after a seven-year stretch as a paramedic, had developed the talent of perfectly starting IVs anywhere in the back of the ambulance and nowhere else. Hari was a first-generation Indian, son of native Hindi parents, proud recipient of their boasting. At thirty-eight, he was ten years older than Kat, but he couldn’t be happier under her command. Jess was younger - twenty three. She got her EMT license in her last year of high school and, despite her tendency for hot-headed outbursts, was a loyal EMT and working her way up to an advanced EMT license.   
Aaron Hotchner was in the hospital bed, listlessly watching some awful television show they always played in the hospital.   
“Hotchner?”   
The man startled and glanced over. Kat slid off Hari’s back and said,  
“We were the responding ambulance to your call. How are you? Getting better?”   
“Could be better.”  
“You have any visitors yet?” Hari asked, always concerned for the patient’s mental well-being.  
“My son is at school.”  
“Co-workers?”  “In Colorado.”   
Hari and Kat blinked.  
“Wait,” Jess said, sounding excited and bouncing forward, “I knew it! You’re an FBI dude, right?”   
Hotchner nodded.  
“I saw his badge on the table.” Jess said, turning to Kat like a puppy seeking praise.  
“Cool.” Kat said, leaning against the doorway, “Well, we’re glad you’re feeling better, Mr. Hotchner. Don’t hesitate to call us if you need us again.”   
“Duly noted.”


	2. 13/01/2009 1900 hours

**Summary for the Chapter:**

> Extrications are tricky. Getting a patient out of a crumpled car, onto a backboard, and in an ambulance without hurting them more is hard. The car is ruined - no fireman would pass up on an opportunity to literally rip the door off a car. But add freezing weather, nighttime, and a cardiac arrest midway through, well, it just makes team 158 regret their turnout gear.

“Ambulance 158, respond to a code two three-car MVA at 495 and Capital Beltway, repeat, 158, respond to three-car MVA. Fire and additional ambulances are on their way.”  
Kat glanced up from her book and took the microphone.  
“158 en route.”  
“158 en route, 1900 hours.”  
Kat shifted into drive, and, with an evil smile tilting her lips, flipped on all the lights and hit the air horn. Hari jolted in his seat and hit his head on the window. He swore briefly in Hindi and glared at Kat.  
“I’m going to make you run attending for all forty-eight hours if you keep doing that.”  
“Oh, no.” Kat said, staring ahead and keeping her voice monotone, “Boss people around for the entire shift? I would hate that.”  
Hari rubbed the back of his neck.  
“Shut up, bossy-pants.”  
Kat rolled her eyes and yawned. Twenty-seven hours into the forty-eight hour shift, and they had just shifted attending positions at the twenty-four hour marks. These shifts were long, hard, and generally thankless, but they wouldn’t have it any other way.  
Kat habitually ran through protocol before calls like these.  
/Okay, three-car MVA. Fire’s probably going to get there before us, so they’ll set up a perimeter. I’ll park my bus within the safety zone and get out the reflective vests. I’ll get Hari and Jess to get the KED, backboard, kit, pram. I’ll go check out the victims, choose based on life threat, and get Jess to provide in-line stabilization. Oh, shoot, asshole, MOVE!/  
Kat hit the airhorn and the car meandering in front of them darted off to the right side of the road, thankfully not causing another crash on their way to the scene. Nowadays, people were notoriously inattentive on the road and didn’t see the lights of the ambulance until the driver hit the air horn.  There were few things Kat McArther loved more than driving an ambulance. She kept 158 in pristine condition - always clean, despite how muddy or potentially snowy the roads may be. The engine ran like a dream, starting up with a throaty roar and humming like a kitten as they darted around cars and through stoplights to get to the scene. Hari napped in the seat beside her, coat drawn tightly over his chest to combat the chilly January weather. Jess’ kindle clicked softly in the background, and Kat blew a blue piece of hair out of her face.  
She pulled into the safety zone created by the two fire trucks on the highway and flipped off the strobe light, leaving the rest of them to create as visible of a scene as possible. Jess poked her head into the small space between the driver’s seat and passenger’s seat and gave the two reflective vests.  
“Thanks, love.” Kat said, “You have your jacket?”  
Jess rolled her eyes.  
“Yes, mom.”  
“This isn’t going to be comfortable.” Hari groaned, uncurling from the seat, “Grab a Kendrick and a backboard, will you? I’ll go make contact.”  
Oh, right, I’m not running attending.  
In the back of the ambulance, completely deadpan, Jess started a Kendrick Lamar song. She lasted about ten seconds before bursting into laughter, and Hari smacked her playfully.  
“You’re so funny, nonu.”  
Hari opened the side compartment on the left side of the ambulance and shivered.  
“It’s really cold, guys. Get bunker gear on and stay moving, if you can.”  
The cold hair hit Jess and Kat like a hammer, stealing their breaths away and turning it into puffs of white as the moon rose up in the sky. Hari set two pairs of pants on the ground, and quickly, because it was really freaking cold, they stepped out of their shoes and into the boots. Kat pulled up the pants and hooked the suspenders over her shoulders, and a firemen came wandering over.  
“I did always like a girl in turnout gear.” he said playfully, “You guys are the second ambulance to arrive. We got one guy out already, the two others are stable, just hard to extricate.”  
Kat buttoned up the coat and pulled on a pair of gloves, sighing as she began to warm up.  
“Velocity of the crash?” Hari asked as they clomped over to what was left of the three cars.  
“Surprisingly, we had one ambulatory. He was in the second car, and he said they were going about fifty-five. Third car was going faster. We estimated sixty-five. First car was the worst - guy starred his head on the windshield and you could see the crack in his frontal bone. Shoulda kept the eye that fell out, too.”  
“Ew, Mike.” Kat said, “Freeze the eye, don’t put it in your pocket.”  
Mike grinned.  
“You are positively awful.”  
“Bossy, too.” Kat said, “Hari, stabilization?” Hari nodded at her. Kat knelt by the open driver’s side of the car, the door torn of and resting in front of the car’s smashed nose, and assessed the patient briefly for competency. She was awake, skin color was pale and cold, but the only obvious sign of bleeding was from her head. One of the firemen had already gotten a c-collar on her and was sitting in the backseat of the car, holding the girl’s head with two hands.  
“Ma’am, my name is Kat, I’m a paramedic, I’m here to help. Do you know where you are right now?”  
“In a car.”  
“What’s your name?”  
“Allie.”  
“Hi, Allie. Do you know what today’s date is?”  
“No.”  
“How old are you, Allie?”  “Nineteen.”  
The poor girl sounded close to tears. There was already a blanket around her, but she was still shivering, so Kat turned around and yelled,  
“Jess, can you bring me another blanket?”  
Jess hollered back an affirmative, so Kat turned back to Allie.  
“Alrighty, Miss Allie, we’re going to get you out of here as quick and as safely as we can so we can get you somewhere warm. My buddies are already turning the heat on full-blast in the ambulance, so that’s going to be delightful. Fire, what’s your name?”  
“Tim.”  
“Thanks, Tim, I can take over from here. You guys can continue with whatever extrication you were planning.”  
“Okay.”  “I’ll climb in through the other side and take your place, okay?”  
Tim nodded.  
Kat opened the door opposite Tim and wormed her way into the small, silver sedan. Carefully, Tim and Kat changed places on maintaining in-line stabilization, and Kat settled in to wait for a while.  
Hari got to the car with Kat making casual conversation with the girl.  
“Hey, Hari, this is Allie. Nineteen.”  
“Hi, Allie, I’m Hari. Did you get a report from the medic on her neck?”  “No obvious deformities, complaining of pain in central c-spine, CMS good before and after, no JVD, no tracheal deviation.” Kat reported.  
“Good. Allie, does anything else hurt besides your neck?”  
“My chest.” Allie said, “It’s hard to breathe.”  
Hari gently palpated over her chest and caught his lower lip between his teeth. He opened his mouth to order for some oxygen, but Jess popped up behind him and said perkily,  
“Need some oxygen?”  “Jess, you read my mind.” Hari said, “You got it?”  “Yup. I’ll do vitals, too.”  
“Good girl.”  
Hari gently felt over her chest and laid his palm over a section in the upper right hand quadrant. If it weren’t for his fifteen years as a paramedic, he would have frowned and diagnosed a flailed chest right off the bat, but the patient remaining calm during an extrication is a top priority. So he just patted Allie’s leg gently and said,  
“I’ll be back in just a second. We’re gonna need some handsome firefighters to help get you out of here and into the warm ambulance.”  
Hari stood up and went over to two of the firefighters who were getting out a backboard and a Kendrick.  
“We can’t use the Kendrick.” Hari said, “She’s got a flailed chest and a possible femoral fracture. Can you guys be ready for backboard support?”  
“Sure.”  
Two firemen followed Hari back to the car, where he completed a secondary assessment. Allie had a compound fracture in the tib-fib area, and Hari could see part of the bone sticking through her skin, white and bloody. He quickly assessed circulation in that foot and frowned - the capillary refill in the bed of toenails was slow, which meant that something in that leg was pressing against a vein or an artery and decreasing blood flow to the lower half of the leg, which left untreated could cause necrosis and eventual amputation.  
“Jess, get me a splint, tib-fib.” Hari said.  
The splint landed beside him a moment later and Jess darted back to keep monitoring Allie’s vital signs.  
Extrications are slow, occasionally agonizingly so. Hari, Jess, Kat, and the team of three firefighters had to help Allie lift her butt up off the seat and slide the backboard under her without further damaging her legs. As they were ruminating briefly on ways to shift her legs to the right so they could slide her back on the backboard, Jess deflated the pressure cuff and said,  
“Uh, guys,” just as Allie went limp.  
The extrication went a lot quicker after that. Because of a combination of the cold, trauma, and the loss of blood from her leg, Allie had gone into cardiac arrest, and at this point the team was less concerned about her spine and more concerned about her life. One of the firemen helped swing Allie’s legs to the right as Hari checked for life signs, and as soon as they got her on the backboard, strapped in, and onto the pram, Jess climbed on top and started CPR.  
“She’s not unconscious enough for a king tube, Kat, get an OPA in.” Hari ordered, pushing the pram towards the ambulance. Kat climbed up on the side of the pram, swaying slightly with the movement, and as Jess went into another round of compressions, Kat moved Allie’s tongue out of the way through the use of the curved plastic device that was an OPA. Her gag reflex was gone, thankfully, so the firefighter and Kat continued with breaths. As they got into the ambulance, one of the firemen climbed in with them and Hari took off.  
With the heat on full blast and all the team in their bunker gear, it was getting hot really quickly, but Allie was practically hypothermic, so no-one complained. Kat put the firemen on breaths for a minute to cut open Allie’s shirt and take off her bra, and then stuck the pads for the AED on her chest. Then she started an IV in Allie’s left arm and pushed a few drugs that would hopefully start her heart again.  
As Hari got them to the hospital, driving as carefully but as quickly as he could on the chilly January night, Hari called it in.  
“We’ve got a nineteen year old female, Allie Fitzsimmons, MVA that was on 495 and Capital Beltway. Currently in cardiac arrest, CPR in progress. History obtained: no allergies, mild asthma, surgery to remove her wisdom teeth six months ago. Tibial compound fracture, possible femoral fracture, cap refill of same fractured leg delayed. Complains of c-spine pain, pushed epi twice. ETA four minutes.”  
“Roger, 158, we have a team ready for you.”  
After four minutes of CPR, there was spontaneous return of pulse at seventy-two beats per minute, so Jess got off the pram, sat on the bench, and sighed, and Kat ran an EKG strip to confirm. Her breathing was still labored and insufficient, so Kat and the fireman continued breathing for her until they unloaded at Washington General and gave the pass-off report.  
After Allie had been rolled inside and all the proper forms signed, Hari radioed in and said,  
“Dispatch, please hold next call for us as we’re all weirdly hypothermic and heat exhausted.” Liz sounded faintly amused.  
“Gotcha, 158.”  
They drove back to the barn a couple blocks away from Washington General, where there was a plump woman with bright red hair waiting inside, talking eagerly about the newly-updated Opticom system. 158 honestly couldn’t care less, though, so they trudged past the woman in sweaty bunker gear until she said,  
“Oh, blue hair! Hey!”  
Kat turned around.  
“Hi.”  
“Um, I brought you cookies. As a thanks. For saving my boss. We can’t really function without him, so, um, thank you.”  
The woman held up a red box that smelled delightful. Jess sighed happily and, after throwing her turnout jacket up on a hook, said,  
“You are a godsend. Oh, god, they’re still warm. We just spent two hours on 495 in an extrication, and I don’t know if I’m cold or hot. I’m Jess. Who are you?”  
“Penelope. Penelope Garcia.”  “So you’re FBI, too?”  “Techie. Nerd. I have my own kingdom in there, practically. Um, you guys look exhausted. I can, like, leave.”  
“No, no, you brought cookies, you stay for at least a little while. Bring baked goods to any station and you’ve got friends for life.” Hari said, “Hari. Nice to meet you.”  
The three shed the rest of their bunker gear and enjoyed a few minutes of peace and general, tolerable warmth. They were munching on cookies and discussing the calming qualities of baby panda pictures when a tone rang out. Automatically everybody in the barn went quiet, Penelope too, after a second of hesitation.  
“158 and 159, respond to a domestic violence call, 149 Washington Ave.”  
George, attending paramedic for 159, groaned in tandem with Hari.  
“This guy?” Jess asked, frowning, “Again? Ugh. Sorry, Pen, we’ve gotta go.”  
“Sure, sure.” Penelope said, “Thanks again, guys.”  
Her phone beeped and she glanced at it.  
“Actually, I have to go to. Be safe!”  
Hugs were exchanged, then 158 and 159 peeled out of the barn and down to the same assault victim that they’ed gotten at 0200 hours almost every night for the past week.  
In the ambulance, Jess poked her head between the two seats and said,  
“Those cookies were amazing.”  
Hari nodded, stretching luxuriously in the seat.  
“She should come more often.”

**Notes for the Chapter:**

> BVM stands for bag valve mask. It's how we first-responders can breath for a patient in respiratory arrest. Extrications are fun, but they're painful. I spend thirty minutes today hunched in the back of a sedan trying to get someone out without paralyzing them. Of course, it's all practice, so in the real world, they take even longer. Fun, fun! Also, a Kendrick Extrication Device is an, surprise, extrication device that's sort of like a half-backboard with three straps that you slide behind a seated patient to stabilize their spine before then getting them on a backboard. Thus, many Kendrick Lamar puns shall be made.  
> Also, I'm still trying to figure out formatting. Bear with me here, folks.  
> Cheers,  
> rae_z

**Author's Note:**

> 'Sup.   
> I'm in school to be an EMT, so I'm trying to make this as medically accurate as possible. I don't censor, like, at all, so if all the clinical descriptions of blood and guts and core and macabre jokes don't float your fancy, then don't read.   
> Really I write this because I'm bored. Don't expect something as amazing as Shards to a Whole, just saying. 
> 
> Cheers,  
> rae_z


End file.
